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Introduction Repeated sports-related concussion has been associated with cognitive deficits, like other forms of traumatic brain injury. Football speed players (FSP; e.g., quarterbacks) are at greater risk of cognitive impairment compared to football non-speed players (FNP). Verbal fluency is typically comprised of two tasks: letter fluency (LF) and semantic fluency (SF). Verbal clustering (production of continuous words belonging to the same category or subcategory) and switching (abandoning an exhausted semantic cluster to a new one in order to produce more words) reflect executive control and strategy use. We examined LF, SF, as well as LF and SF switching and clustering performance in retired FSP, FNP, and healthy comparison (HC) participants. Methods The sample consisted of 28 HC, 17 retired FSP, and 53 retired FNP. ANOVAs were conducted to determine group differences on LF, SF, switching, and clustering. FSP and FNP did not differ in concussion frequency. Results We found the HC group outperformed the FSP group in LF, p = 0.042, ηp2 = 0.07. For SF, the HC and FNP groups outperformed the FSP group, p = 0.013, ηp2 = 0.09. Furthermore, we found the HC group outperformed both football groups in SF switching, p = 0.000, ηp2 = 0.17. Conclusion As expected, the HC group outperformed the FSP group on LF and SF. Also, the FNP group outperformed the FSP group on SF. Interestingly, FSP displayed generally worse performances, supporting the notion that their experience of sub-concussive blows puts them at greater risk for cognitive impairment. Further investigation is needed with larger sample sizes to evaluate SF and other cognitive deficits in the FSP participants.

Objective Traumatic brain injury (TBI) survivors exhibit cognitive deficits. Research suggests that multilingualism can influence neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and cognitive speed (i.e., Symbol Digit Modalities Test; SDMT). Method The sample consisted of 55 healthy comparison (27 Spanish-English bilinguals; 28 English-monolinguals), 34 acute TBI (14 Spanish-English bilinguals; 23 English-monolinguals), and 27 chronic TBI (13 Spanish-English bilinguals; 12 English-monolinguals) participants. Acute TBI participants were tested 6 months post-injury; chronic TBI participants were tested 12 months or more post-injury. A series of 3X2 ANOVAs were conducted to determine the effect of TBI and language on SDMT written and oral performance. Results ANOVAs revealed the healthy comparison group outperformed both TBI groups on SDMT written, p = 0.000, ηp2 = 0.21. Also, the healthy comparison and chronic TBI groups outperformed the acute TBI group on SDMT oral, p = 0.000, ηp2 = 0.13. Interaction effects emerged between TBI and bilingualism/monolingualism. On SDMT written and oral, acute TBI English-monolinguals outperformed acute TBI Spanish-English bilinguals; meanwhile, chronic TBI Spanish-English bilinguals outperformed chronic TBI English-monolinguals, p Conclusion The acute TBI group performed worse than healthy comparison adults on both SDMT tasks. Furthermore, the chronic TBI group demonstrated better SDMT oral abilities compared to the acute TBI group. Relative to monolinguals with TBI, our findings suggest better cognitive recovery of attention and cognitive speed in bilingual TBI participants. Future studies with larger sample sizes should examine if learning English first or second impacts Spanish-English bilingual TBI survivors’ SDMT performance compared to English-monolingual TBI survivors.

Objective We examined perceived workload as it is related to Brief Visual Memory Test-Revised (BVMT-R) short-delay and long-delay performance in traumatic brain injury (TBI) and healthy comparison (HC) participants. Method The sample consisted of 39 TBI participants and 54 HC participants. Demographically corrected BVMT-R scores were used to evaluate short-delay and long-delay performances. The perceived workload was measured using the NASA-TLX. Results ANOVA revealed that the HC group outperformed the TBI group on the BVMT-R short-delay and long-delay score, p Conclusions Results revealed that TBI participants demonstrated worse BVMT-R performances than HC participants. However, TBI survivors reported higher perceived workload demands compared to the HC group in both short-delay and long-delay of the BVMT-R. Our findings suggest that TBI impacts non-verbal memory performance in both BVMT-R short-delay and long-delay. Also, brain injury may be impacting TBI survivors’ awareness of their non-verbal memory performance. Further work is required to determine what drives the impaired perception of non-verbal memory performance among TBI survivors.

Objective The United States carries a diverse Latinx population. This population largely consists of Mexicans however, there has been a population decrease since 2010. Though, the Guatemalan population has increased since 2010 and has become the third most growing population in the United States. Previous research shows that level of acculturation influences neuropsychological test performance. The Córdoba Naming Test (CNT) is a confrontation naming test created for Spanish-speakers. We examined the relationship between acculturation and CNT performance in a Latinx sample that immigrated to the United States. Method The sample consisted of 44 Mexicans and 14 Guatemalans that were neurologically and psychologically healthy residents. All the participants completed the CNT and the Abbreviated Multidimensional Acculturation Scale (AMAS) in Spanish. ANOVAs were used to examine CNT performance and acculturation on the AMAS subscales. Results Results revealed the Guatemalan immigrant group outperformed the Mexican immigrant group on the CNT, p = 0.035, ηp2 = 0.08. Additionally, we found that on the English language subscale of the AMAS, the Mexican immigrant group reported higher English language levels than the Guatemalan immigrant group, p = 0.002, ηp2 = 0.16. Conclusion Our findings showed that Guatemalans demonstrated better CNT performance compared to Mexicans. To our knowledge, this is the first study to examine confrontation naming performance in a Latinx immigrant sample. Furthermore, we found that Mexicans reported higher English language compared to Guatemalans. Future research on the CNT with larger samples should investigate possible interactions between acculturation and other cultural variables (e.g., bilingualism) in the interpretation of test performance in a Latinx immigrant population.

Objective Both anxiety and traumatic brain injury (TBI) are both related to poorer Trail Making Test (TMT) performances. TBI survivors exhibit a greater incidence of anxiety in contrast to the general population. We evaluated the relationship between TBI and anxiety on TMT and perceived workload ratings. Method The sample consisted of 39 moderate-to-severe TBI [(21 with normal symptoms of anxiety (NSA) and 18 with abnormal symptoms of anxiety (ASA)] and 51 healthy comparison (HC; 26 NSA and 25 ASA) participants. Results ANCOVA’s, controlling for age, revealed the HC group outperformed the TBI group on TMT part A and TMT part B (TMT-B). An interaction emerged on TMT-B, with TBI-ASA participants outperformed TBI-NSA participants and HC-NSA participants outperformed their counterparts with ASA. Ratings of physical demand and frustration were reported higher in TBI participants compared to the HC participants. Moreover, TBI and anxiety symptoms had interactive effects on NASA-TLX temporal demand and frustration ratings, were TBI-ASA participants reported higher scores in contrast to TBI-NSA. Lastly, an interaction emerged with HC participants with ASA reporting better performances in contrast to HC-NSA. Conclusions As expected, TBI participants did worse on both TMT tasks. Next, we found that TBI-ASA participants impacted their TMT-B performance and their perceived workload (i.e., frustration, temporal demand) more than TBI-NSA participants. In the future, studies with a larger sample size should examine if anxiety influences TMT performance and perceived workload in person with mild TBI.

Introduction Repeated sports-related concussions have been associated with cognitive deficits, similar to other forms of traumatic brain injury. We investigated three different measures of executive ability derived from the Trail Making Test part B (TMT-B) in healthy comparison (HC) adults and retired football players. Methods The sample consisted of 32 HC, 15 retired football speed players (FSP; e.g., quarterbacks), and 53 retired football non-speed players (FNP) participants. Participants were administered both TMT part A (TMT-A) and TMT-B, and total time for completion was recorded. A series of ANCOVAs, controlling for age and education were conducted to evaluate group differences in executive abilities. Executive measures included the TMT-B raw score (i.e., seconds to complete TMT-B), the raw score difference (in seconds) between TMT-A and TMT-B (TMT-BA), and the difference between a predicted TMT-B score (TMT-BP) and the obtained TMT-B score (TMT-BBP). Correlations between TMT-B, TMT-BA, and TMT-BBP and other executive functioning tests (i.e., letter fluency and animal naming) were evaluated. Results Results revealed that the HC group outperformed both retired football player groups on all measures of executive ability derived from TMT-B, p’s Discussion We found that the HC group outperformed both retired football player groups on all three TMT variables. In our retired FNP sample, more TMT variables correlated with executive functioning measures which suggests that TMT-B and TMT-BA are likely better measures of executive ability than TMT-BBP.

Introduction We examined the impact of perceived workload and depressive symptoms on Rey-15 plus recognition (RMT) in ethnic minority participants with traumatic brain injury (TBI). Methods The sample consisted of 63 healthy comparison [HC: 38 with ethnic minority status (EM) & 25 non-ethnic minority Caucasian (NEM)] participants and 40 persons with TBI (18 EM; 22 NEM). The Hospital Anxiety and Depression Scale to measure depressive symptoms (HADS-D) and the NASA-Task Load Index (NASA TLX) to measure perceived workload. Results ANCOVAs revealed that NEM outperformed EM on the RMT, p = 0.000, ηp2 = 0.37. TBI survivors reported higher levels of HADS-D compared to HC participants, p = 0.018, ηp2 = 0.06. Additionally, the EM group reported higher levels of frustration on the RMT compared to NEMs, p = 0.033, ηp2 = 0.05. Interactions emerged for physical demand where NEM participant’s with TBI had higher ratings than EM participants with TBI. For HCs, the EM participants provided higher physical demand ratings than their NEM counterparts, p = 0.029, ηp2 = 0.05. Additionally, a significant relationship between HADS-D and RMT was observed in the healthy NEM participants (r = −0.558, p = 0.004) and NEM participants with TBI (r = −0.288, p = 0.080). Finally, significant relationships between HADS-D and mental demand, physical demand, temporal demand, frustration, and overall subjective workload were observed in healthy EM participants, r = 0.342–0.431, p Conclusion Consistent with previous research, TBI survivors reported higher levels of depressive symptoms, which were associated with RMT performances. Overall, our data suggest the relationship between perceived workload, depression, and performance is complex and that investigators should interpret performance validity scores in person with TBI, depression, and/or EM status with great care.

Objective We examined two established Spanish-English bilingual norms to assess if traumatic brain injury (TBI) deficits were still found if language was no longer a variable influencing Boston Naming Test (BNT) performance. Method The sample consisted of 47 healthy comparison (HC; 24 English-Monolinguals; 23 Spanish-English Bilinguals), 33 acute TBI (ATBI; 20 English-Monolinguals; 13 Spanish-English Bilinguals), and 25 Chronic TBI (CTBI: 13 English-Monolinguals; 12 Spanish-English Bilinguals) participants. Raw scores and adjusted demographic T-scores (Roberts et al., 2002; Rosselli et al., 1997) were used to evaluate BNT performance. Results An ANCOVA controlling for age, revealed the HC group outperformed the TBI group on the BNT (raw score), p = 0.003, ηp2 = 0.11. We also found monolinguals outperformed bilinguals on the BNT, p = 0.000, ηp2 = 0.24. Using the Roberts et al., (2002) norms, we found the HC group outperformed the TBI group, p = 0.003, ηp2 = 0.11, but no language differences were found. Next, using Rosselli et al., (1997) norms, we found the HC group outperformed the TBI group on the BNT, p = 0.003, ηp2 = 0.11, and monolingual speakers outperformed bilingual speakers, p = 0.014, ηp2 = 0.06. No interactions were found. Conclusions As expected, the TBI group demonstrated worse BNT performance compared to HC group on both language norms. However, when using Roberts et al., (2002) Spanish-English bilingual norms, no language group differences were found. Our data indicates that when examining BNT performance in a Spanish-English bilingual and English-monolingual TBI sample, Roberts et al., (2002) normative data may be better suited to evaluate BNT deficits in a TBI while taking language into account.

Objective We evaluated symptoms of anxiety (via the Hospital Anxiety and Depression Scale; HADS, HADS-A) on Stroop Color Word Test (SCWT) performances in traumatic brain injury (TBI) survivors, as compared to healthy comparison participants (HC). Method The sample consisted of 40 acute TBI survivors [ATBI; 30 normal symptoms of anxiety (NSA); 10 abnormal symptoms of anxiety (ASA)], 30 chronic TBI survivors (CTBI; 16 NSA; 14 ASA), and 50 HC’s (28 NSA; 22 ASA). All participants passed performance validity testing. The SCWT included the word (SCWT-W), color (SCWT-C), and color-word (SCWT-CW) conditions. A series of ANOVAs were used to evaluate SCWT performances. Results ANOVA revealed a main effect group on the SCWT-C, p = .011, and SCWT-CW, p = .018, with HC’s outperforming the ATBI group. Furthermore, HC outperformed both TBI groups on the SCWT-W, p = .004. We also found that the ASA outperformed the NSA group on the SCWT-W, p = .036. No interactions emerged between group and anxiety. Conclusion The HC group outperformed both TBI groups on the SCWT-W, but only the ATBI group on SCWT-C and SCWT-CW. Furthermore, we found that there were only differences between the anxiety groups on the SCWT-W. Our findings highlight that anxiety impacts HC and TBI groups differently on the SCWT.

Objective McCaul et al. (2018) recently revised the Dot Counting Test (DCT) cut-off score from ≥17 to 13.80; we evaluated the new cut-off in monolingual and bilingual traumatic brain injury survivors (TBIS) and healthy comparison participants (HCP). Method The sample consisted of 43 acute TBI [ATBI; 23 English monolinguals (EM); 11 English first language bilinguals (EFLB); and 9 English second language bilinguals (ESLB)]; 30 chronic TBI (CTBI; 13 EM; 9 EFLB; 8 ESLB), and 56 HCP (23 EM; 11 EFLB; 22 ESLB). Results An ANCOVA, controlling for age and education, revealed an interaction where ATBI-EFLB had higher E-scores than the other groups and the CTBI-EFLB had lower E-scores than the other groups. Both the conventional and proposed new cut-off (PNC) scores had different failure rates in ATBI (conventional cut-off: 9%; PNC: 28%), CTBI (conventional cut-off: 10%; PNC: 20%), and HCP (conventional cut-off: 11%; PNC: 13%). For language groups, EM (conventional cut-off: 14%; PNC: 22%), EFLB (conventional cut-off: 10%; PNC: 26%), and ESLB (conventional cut-off: 5%; PNC: 10%) demonstrated different failure rates across cut-off scores. Group differences were found with McCaul et al. (2018) cut-off, but not the conventional cut-off score. Also, chi-squared analysis revealed ATBI EFLB and EM had greater failure rates than ATBI ESLB. Conclusion Unfortunately, the new DCT cut-off score resulted in greater failure rates in TBIS. Furthermore, ATBI EM and EFLB were impacted more by the new cut offs than ATBI ESLB who learned English later in life, although the reason for this finding is unclear and requires additional study.

Objective Traumatic brain injury (TBI) is associated with a number of cognitive deficits. Language factors also impact neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and executive functioning (Trail Making Test; TMT). Method The sample (N = 96) consisted of 36 healthy controls (19 bilingual; 17 monolingual), 34 acute TBI participants (12 bilingual; 21 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. 3X2 ANOVAs were conducted to determine the effect of TBI and bilingualism/monolingualism on TMT part A and B. Results Main effects were found between groups (i.e., control and TBI groups) on TMT A, p < .001, ηp² = .17 and TMT B, p < .05, ηp² = .09. Pairwise comparisons revealed a difference only between the control group and the 6-month TBI group, with the latter performing worse. Main effects were found for bilingualism/monolingualism on TMT A, p < .05, ηp² = .04 and TMT B, p < .05, ηp² = .05; monolingual participants performed better than bilingual participants. No interactions emerged. Conclusion Relative to monolinguals, bilingual participants demonstrated worse attention and executive functioning performances 6 months post-TBI; however, 12 months post-TBI, the difference was negligible.

Objective Traumatic brain injury (TBI) survivors often exhibit problems with executive function (EF). Language use can also impact EF test performances. We examined the effects of TBI and bilingualism/monolingualism on several EF tests. Method The sample (N = 94) consisted of 37 healthy controls (19 bilingual; 18 monolingual), 30 acute TBI participants (10 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. Stroop Color-Word (SCW), Delis-Kaplan Executive Function System Letter Fluency (DKEFS-LF), Trail Making Test part B (TMT-B) and a EF global composite (EF-GC) were used to assess EF. All participants passed performance validity testing. 3X2 ANOVAs were conducted to determine the effect of TBI and bilingualism/monolingualism on EF performances. Results Main effects were found between groups (control and TBI groups) on SCW, p = .046, ηp² = .07, TMT-B, p = .042, ηp² = .07, and EF-GC, p = .005, ηp² = .13; the 6-month TBI group performed worse than controls on TMT-B and EF-GC. Main effects were found for bilingualism/ monolingualism on SCW, p = .012, ηp² = .07, and TMT-B, p = .034, ηp² = .05; monolingual participants performed better than bilingual participants. No significant interactions between TBI and language were found. Conclusion The TBI group underperformed on SCW, TMT-B, and EF-GC compared to controls; relative to monolinguals, bilinguals underperformed on the SCW and TMT-B only. In conclusion, our findings seem to suggest that monolinguals have better cognitive flexibility compared to bilinguals that result in better EF performances.

Objective Traumatic brain injury (TBI) impacts neurocognitive function. Language is also known to influence test performances. We examined the relationship between TBI and monolingualism/bilingualism on verbal and design fluency tests. Method The sample (N = 74) consisted of 33 healthy controls (18 bilingual; 15 monolingual), 15 acute TBI participants (6 bilingual; 9 monolingual), and 26 chronic TBI participants (15 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. The Delis-Kaplan Executive Function System Letter Fluency (DKEFS-LF), Category Fluency (DKEFS-CF), Category Switching Fluency (DKEFS-CSF), and global verbal fluency composite (DKEFS-GVF) scores assessed verbal fluency; DKEFS fill-dots (DKEFS-FD), empty dots (DFEFS-ED), dot switching (DKEFS-DS), and global design fluency composite (DKEFS-GDF) scores assessed design fluency; and global verbal and non-verbal fluency composite (DKEFS-GF) assessed overall fluency. 3X2 ANOVAs were conducted to evaluate the effect of monolingualism/bilingualism on fluency performance in TBI and controls. Results The groups (control and TBI groups) differed for DKEFS-LF, p = .048, ηp² = .09, DKEFS-CF, p = .000, ηp² = .21, DKEFS-GVF, p = .004, ηp² = .15, DKEFS-ED, p = .008, ηp² = .13, DKEFS-GF, p = .001, ηp² = .20, with controls outperforming TBI groups on the DKEFS-CF, DKEFS-GVF, and DKEFS-GF. Furthermore, controls outperformed acute TBI participants on the DKEFS-LF and DKEFS-ED. Main effects were found for bilingualism/monolingualism on DKEFS-CF, p = .035, ηp² = .06, with bilinguals outperforming monolinguals. No interactions were found. Conclusion The TBI group had poor verbal and design fluency in contrast controls. Unexpectedly, bilinguals outperformed monolinguals on a task of verbal category fluency. Revealing that in the present study bilinguals have better semantic verbal fluency abilities.

Objective Traumatic brain injury (TBI) survivors exhibit cognitive deficits. Language factors can also influence neurocognitive performance. We examined the effects of TBI and bilingualism/monolingualism on a test of attention and cognitive speed (i.e., Symbol Digit Modalities Test; SDMT). Method The sample (N = 98) consisted of 37 controls (19 bilingual; 18 monolingual), 34 acute TBI participants (12 bilingual; 22 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury; chronic TBI participants were tested 12 months or more post-injury. All participants passed performance validity testing. 3X2 ANOVAs were conducted to determine the effect of TBI and language on SDMT written and oral performance. Results A main effect was found between groups (control and TBI groups) on SDMT written, p < .001, ηp² = .19 and SDMT oral p < .001, ηp² = .16. Pairwise comparisons revealed a difference between the control group and TBI groups, with TBI groups performing worse. A main effect for bilingualism/monolingualism was not found; interaction effects emerged between TBI and bilingualism/monolingualism on SDMT written, p < .05, ηp² = .07 and SDMT oral p < .05, ηp² = .07. Conclusion TBI groups performed worse than controls on the SDMT. Relative to monolinguals with TBI, our findings suggest better cognitive recovery of verbal attention and cognitive speed in bilingual TBI participants.

Objective The Boston Naming Test (BNT) is a lexical-retrieval task. It has been documented that those with a history of traumatic brain injury (TBI) have reduced performance on the BNT. Bilingualism is also known to impact BNT performances. We examined the relationship of TBI and bilingualism/monolingualism on BNT performances. Method The sample (N = 95) consisted of 36 healthy controls (19 bilingual; 17 monolingual), 32 acute TBI participants (12 bilingual; 20 monolingual), and 27 chronic TBI participants (16 bilingual; 11 monolingual). Acute TBI participants were tested 6 months post-injury and chronic TBI participants were tested 12 months or more post-injury. All participants passed performance validity testing. A 3X2 ANOVA was conducted to determine the effect of TBI and bilingualism/monolingualism on BNT performance. Results A main effect was found for group (i.e., control, 6 month TBI, and 12 month TBI), p < .001, ηp² = .21. Pairwise comparisons revealed that acute TBI participants performed worse than the control and chronic TBI groups. A main effect for bilingualism/ monolingualism was found, p < .001, ηp² = .14; monolinguals performed better on the BNT. No interactions were found between TBI and bilingualism/monolingualism. Conclusions BNT performance improves overtime in TBI and the pattern of improvement post-TBI is not statistically different between bilingual/monolingual groups. Relative to monolinguals, bilingual participants demonstrated worse BNT performance.